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Medicare Pricing Follies.

Discussion in 'Other Health News and Research' started by Ema, Nov 26, 2013.

  1. Ema

    Ema Senior Member

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    I thought this was a great piece that captures the frustrations with Medicare...

    http://www.anh-usa.org/medicare-pricing-follies/
  2. Ema

    Ema Senior Member

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    This one is pretty spot on as well:

    http://www.anh-usa.org/what-if-grocery-stores-were-run-like-healthcare/
  3. minkeygirl

    minkeygirl Is Jim Jones alive and well on PR?

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    I've learned over the years that you can call Medicare 5 times and get 5 different answers.

    I've had good doctors opt out because they dont want to deal with Medicare. Not just for that reason but because they do t want to be hamstrung by the constraints.

    Is it any wonder there are no ME docs in Medicare? 15 minute appointments, treatments not approved, labs not covered. Who'd want to have to deal with that?
    Valentijn likes this.
  4. Ema

    Ema Senior Member

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    Actually, Lerner does take Medicare patients. If he didn't, I would never have been able to afford cidofovir with all the associated travel expenses. But you're right that the vast majority don't. My LLMD, for example, does not participate with any insurance companies at all which is also typical. You can't take a thorough history in 15 min.
    Valentijn likes this.
  5. minkeygirl

    minkeygirl Is Jim Jones alive and well on PR?

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    @Ema I should have clarified and said medicare HMO's which I think are even more restrictive.

    My PCP does do 1/2 appts but she's clueless and ME
  6. SickOfSickness

    SickOfSickness Senior Member

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    Maybe because he can bill as a specialist? I believe specialists get around 160%-167% payment that a GP gets. (And maybe more?) Copay is 160%-167% for many of the Medicare Advantage plans. It may depend on the specialty, what diagnosis code is used, and other factors.

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